| NPI | 1073243754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3017918) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71013176A) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-10-31 |