| NPI | 1801032594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005902) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 47007) |
| Enumeration Date | 2008-12-30 |
| Last Update Date | 2011-01-21 |