| NPI | 1194393991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3016174) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71013775A) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2023-08-01 |