| NPI | 1558671701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008359) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 561536) |
| 163W00000X Registered Nurse (Licence: KY 1127180) | |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2016-06-17 |