| NPI | 1821053075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3003247) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3247P) |
| 363L00000X Nurse Practitioner (Licence: IN 71001123A) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2024-11-13 |