| NPI | 1295083517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71004079A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1113681) |
| 363L00000X Nurse Practitioner (Licence: KY 3007666) | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2015-06-24 |