| NPI | 1043602089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015005067) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76724) |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2021-04-07 |