| NPI | 1962638296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4195P) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: KY 4195P) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2012-04-17 |