| NPI | 1063883338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6445) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009765) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2019-04-04 |