| NPI | 1245510759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007013) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71003656A) |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2014-03-17 |