| NPI | 1154370856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3004548) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 710040710A) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2022-06-09 |