| NPI | 1568903458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013046) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71010088A) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 2016025419) | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2022-08-30 |