| NPI | 1528438041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009745) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71006858A) |
| Enumeration Date | 2015-09-26 |
| Last Update Date | 2019-01-17 |