| NPI | 1457532483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3005476) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1098915) |
| 363L00000X Nurse Practitioner (Licence: KY 5476P) | |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2020-10-12 |