| NPI | 1619148855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006064) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71010813A) |
| Enumeration Date | 2008-03-16 |
| Last Update Date | 2021-05-24 |