| NPI | 1821068552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 2287P) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 2287P) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2011-02-22 |