| NPI | 1730319419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006096) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1098853) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2017-12-28 |