| NPI | 1649601212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3008450) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1120495) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2015-04-13 |