| NPI | 1164912192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008060A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012106) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2019-03-05 |