| NPI | 1609128131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007590) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY APN3007590) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2015-05-18 |