| NPI | 1619636719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017591) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: IN 28196560A) |
| 163WX1500X Registered Nurse, Ostomy Care (Licence: IN 28196560A) | |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2022-09-14 |