| NPI | 1528581618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012772) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71007274A) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71007274A) | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2019-01-10 |