| NPI | 1194714998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004786) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71002014A) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2011-08-30 |