| NPI | 1518916329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 40176) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KY 4440P) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-11-28 |