| NPI | 1639725203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014343) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1143336) |
| 163W00000X Registered Nurse (Licence: OH 399333) | |
| 163W00000X Registered Nurse (Licence: IN 28215508A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71009456A) | |
| Enumeration Date | 2019-08-10 |
| Last Update Date | 2021-01-11 |