| NPI | 1407122351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IN 71006724A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: KY 3007411) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: OH COA.13168-NP) | |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2019-02-25 |