| NPI | 1518980762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3002126) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3002126) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2018-12-20 |