| NPI | 1710971031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 4159P) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001676A) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-07-09 |