| NPI | 1033574983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3010400) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71006070A) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: IN 71006070A) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: KY 3010400) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: IN 28180181A) | |
| Enumeration Date | 2015-12-19 |
| Last Update Date | 2023-01-25 |