| NPI | 1952399628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3003915) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001703A) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2018-03-21 |