| NPI | 1053861500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008817A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010487) |
| Enumeration Date | 2016-10-08 |
| Last Update Date | 2021-01-13 |