| NPI | 1770551319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: KY 2609P) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1072465) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2012-02-06 |