| NPI | 1104343714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012171) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28238593A) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2019-05-14 |