| NPI | 1699759902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004429) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71002054A) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2023-03-07 |