| NPI | 1104443480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014730) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71011150A) |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2024-05-14 |