| NPI | 1750383279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004047) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4047P) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2011-01-25 |