| NPI | 1992078158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010168) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007250) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 300725) | |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2018-01-19 |