| NPI | 1912551870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3011935) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71009550A) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3011935) | |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2020-08-18 |