| NPI | 1831445022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 16723) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3007811) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2014-02-04 |