| NPI | 1124373238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012022376) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 75840) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2016-02-18 |