| NPI | 1083890461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO MO2001019721) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45766) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2020-08-24 |