| NPI | 1962742056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3007965) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 3007965) |
| 363L00000X Nurse Practitioner (Licence: KY 3007965) | |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2016-06-06 |