| NPI | 1164961074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019023363) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77563) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2020-12-01 |