| NPI | 1568552362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005078) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 5078P) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2016-07-09 |