| NPI | 1639428642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY KY3007656) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007656) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2015-04-20 |