| NPI | 1982640603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3003470) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001152A) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-12-04 |