| NPI | 1487906509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004231A) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2020-10-12 |