| NPI | 1558521815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71002664A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 5734P) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2012-08-16 |