| NPI | 1922348622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3008028) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1091574) |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2020-12-07 |