| NPI | 1629321906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007840) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1118567) |
| 363L00000X Nurse Practitioner (Licence: OH 14010NP) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2021-03-05 |