| NPI | 1790396331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3014915) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71012587A) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3014915) | |
| Enumeration Date | 2020-08-16 |
| Last Update Date | 2022-07-14 |