| NPI | 1114380896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016005845) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 77165) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |