| NPI | 1235512740 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 28237994A) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3009439) | 
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3009439) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH COA.17493-NP) | |
| Enumeration Date | 2015-07-01 | 
| Last Update Date | 2021-02-09 |