| NPI | 1174556468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71000724a) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4488P) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2023-08-15 |