| NPI | 1124488713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009763) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71007969A) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3009763) | |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2018-10-08 |