| NPI | 1649419912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005891) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1083909) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3005891) | |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2019-08-20 |