| NPI | 1285915256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007116) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71004745A) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3007116) | |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2018-05-16 |