| NPI | 1891169744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009937) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71006173a) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2016-07-25 |