| NPI | 1326307018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007416) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71004179A) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-12-19 |