| NPI | 1609262641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3016230) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71005544A) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71005544A) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2021-07-23 |