| NPI | 1538764451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71011041A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3015466) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2021-04-19 |