| NPI | 1639450596 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71005457A) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 13326-NP) | 
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71005457A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3007066) | |
| Enumeration Date | 2011-09-06 | 
| Last Update Date | 2024-10-29 |