| NPI | 1487830048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71001215A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3003464) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3003464) | |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2021-03-30 |