| NPI | 1962782128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007023) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71003614A) |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2022-12-19 |