| NPI | 1841573326 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007028)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 109130)  | 
| Enumeration Date | 2011-09-21 | 
| Last Update Date | 2019-04-25 |