| NPI | 1821157173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3002274) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1074710) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2015-06-04 |