| NPI | 1699766543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 1869P) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3001869) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2011-01-07 |