| NPI | 1568664142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007746) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 291717) |
| 363L00000X Nurse Practitioner (Licence: IN 71004389A) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2021-03-05 |