| NPI | 1710119565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3006234) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 28160661A) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2018-03-17 |