| NPI | 1487630273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3001937) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA132) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2018-03-07 |