| NPI | 1760626402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3005994) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71003103A) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2018-05-14 |