| NPI | 1649642406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009737) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009737) |
| 363L00000X Nurse Practitioner (Licence: IN 71007956A) | |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2020-04-21 |