| NPI | 1104991637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IN 28113704A) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner Community Health (Licence: OH 284585) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2023-03-07 |