| NPI | 1518218791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007702) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004220A) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2020-12-03 |