| NPI | 1114307303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 28181390A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009415) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2017-04-17 |