| NPI | 1497826200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005025) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1057235) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2019-03-20 |