| NPI | 1750750352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009742) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71005876A) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2026-09-04 |