| NPI | 1962882282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009391) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71005460A) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2017-02-10 |