| NPI | 1730142555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71001876A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4749P) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2008-07-17 |