| NPI | 1912928862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004268) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4268P) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2021-01-20 |