| NPI | 1942284252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3002565) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1068451) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: KY 3002565) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2022-11-29 |