| NPI | 1124001839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3002122) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71000912a) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2012-10-25 |