| NPI | 1578152815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3014958) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71011086A) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2023-01-30 |