| NPI | 1124567953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016042122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 77528) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |