| NPI | 1699097592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006232) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: KY 3006232) |
| 163W00000X Registered Nurse (Licence: KY 1040966) | |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2016-05-31 |