| NPI | 1164942694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017021767) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015040563) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 14-123272-031) | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2020-11-10 |