| NPI | 1962648709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005768) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1099826) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 5678P) | |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2023-08-01 |