| NPI | 1518010149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 6161P) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: KY 1066944) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2009-12-10 |