| NPI | 1639386261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002386A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 5597P) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2010-04-28 |