| NPI | 1871550913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3004855) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3004855) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71004448A) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2018-07-24 |