| NPI | 1780649228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005401) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 60951) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 5401P) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2012-02-21 |