| NPI | 1104366376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017004728) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 77623) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2018-08-17 |