| NPI | 1548290315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IN 71002410A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3837P) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2015-11-06 |