| NPI | 1578508420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 5283P) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001072265) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024072265) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2014-05-18 |