| NPI | 1609179266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006949) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 0000015393) |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2015-01-08 |