| NPI | 1053441444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3004801) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3004801) |
| 363L00000X Nurse Practitioner (Licence: IN 71001582A) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-20 |