| NPI | 1164986576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 1136964) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28248284A) |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2021-09-28 |