| NPI | 1548225881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007159) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 35474) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2011-11-22 |