| NPI | 1265544530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005016) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71002201A) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-10-16 |