| NPI | 1174523682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3002509) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3002509) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71001021A) | |
| 363L00000X Nurse Practitioner (Licence: IN 71001021A) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2014-12-08 |