| NPI | 1194204404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71010560A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3015626) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2021-01-05 |