| NPI | 1811179815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006053) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002542B) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2015-11-17 |