| NPI | 1548257637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3003340) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3003340) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71001005A) | |
| 363L00000X Nurse Practitioner (Licence: IN 71001005A) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2017-04-11 |