| NPI | 1578523452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004726) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4726P) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2018-03-20 |