| NPI | 1104107473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011861) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71003742A) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2019-11-01 |