| NPI | 1639767205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3015753) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71010803A) |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2026-08-05 |