| NPI | 1588683320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4099P) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 4099P) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2012-03-28 |