| NPI | 1588914394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007496) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008380A) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2022-12-29 |