| NPI | 1629049010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3001558) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1558P) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2013-05-22 |