| NPI | 1629320619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008543) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28240317A) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 75742) | |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2018-08-22 |