| NPI | 1174070205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017044184) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 153513) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2018-05-31 |