| NPI | 1609863786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004367) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71001828A) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-12-07 |