| NPI | 1104282979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015041115) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 77052) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-02-15 |