| NPI | 1003200080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015007593) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76738) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2015-03-26 |