| NPI | 1174097810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2012017308) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 14-125543031) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-12-31 |