| NPI | 1639431810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007561) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1075008) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2013-05-21 |