| NPI | 1740537562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3007553) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71004163A) |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2015-07-31 |