| NPI | 1558393058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004732) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28167092A) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2011-09-13 |