| NPI | 1346624863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009647) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28190717A) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2016-04-27 |