| NPI | 1871758904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005545) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 5545P) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2020-08-18 |