| NPI | 1568744530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007134) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: KY 3007134) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2018-09-13 |