| NPI | 1699976431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005068) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1092014) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3005068) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2019-10-29 |