| NPI | 1891948170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005786) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 5786P) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2017-02-02 |