| NPI | 1104374966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010625) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71006490A) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2018-05-15 |