| NPI | 1477854115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006704) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006704) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 6704P) | |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2024-02-13 |