| NPI | 1891789814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KY 1020684) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: KY 723A) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2007-07-08 |