| NPI | 1336768993 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71012646A)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3014414)  | 
| Enumeration Date | 2020-04-14 | 
| Last Update Date | 2024-02-21 |