| NPI | 1225657877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3012799) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71009958A) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2022-06-08 |