| NPI | 1083632616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71002383A) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71000831) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3003100) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-06-15 |