| NPI | 1407425606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3016058) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71011445A) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-11-10 |