| NPI | 1548365133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004656) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3004656) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-10-22 |