| NPI | 1497011167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3007444) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1096855) |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2015-10-24 |