| NPI | 1659368744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3004317) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71001757A) |
| 363L00000X Nurse Practitioner (Licence: KY 4317P) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2023-07-22 |