| NPI | 1255747770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009462) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004991A) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2021-01-12 |