| NPI | 1235379215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005741) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 3005741) |
| 363L00000X Nurse Practitioner (Licence: IN 71006183A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3005741) | |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2020-10-28 |