| NPI | 1760628507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 5857P) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1093817) |
| 363L00000X Nurse Practitioner (Licence: KY 1093817) | |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2021-01-26 |