| NPI | 1962438507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3002139) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001137A) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2019-01-25 |