| NPI | 1770504763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200750041NP FNP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY PA401) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2008-06-17 |