| NPI | 1306846803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3002338) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 2338P) |
| 363L00000X Nurse Practitioner (Licence: IN 71000277A) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2013-10-29 |