| NPI | 1861435521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004811) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28160594A) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2015-05-18 |