| NPI | 1386683415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71001791A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3005374) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2013-08-28 |