| NPI | 1801256524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3012719) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71006100A) |
| 363L00000X Nurse Practitioner (Licence: IN 71006100B) | |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2023-03-17 |