| NPI | 1023529211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2018002782) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-106724-091) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2020-01-10 |