| NPI | 1912338534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 30011593) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659970-1) |
| Enumeration Date | 2013-12-07 |
| Last Update Date | 2018-03-17 |