| NPI | 1679608152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3002960) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 2960P) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2019-04-01 |