| NPI | 1912995846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71001829A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4433P) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2015-11-06 |