| NPI | 1487923116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007478) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28194833A) |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2014-11-03 |