| NPI | 1245744960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178628) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71007767A) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3011745) | |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2020-10-20 |