| NPI | 1710236989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 28112401a) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 1060745) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2020-12-02 |