| NPI | 1790921443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3008437) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH 10396) |
| Enumeration Date | 2008-12-31 |
| Last Update Date | 2016-05-31 |