| NPI | 1609183862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006317) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28183928A) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 1056968) | |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2018-03-15 |