| NPI | 1225314578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007150) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28189422A) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2012-05-04 |