| NPI | 1821090952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71002655A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 1174P) |
| 363L00000X Nurse Practitioner (Licence: KY 1047342) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2015-01-16 |