| NPI | 1174555064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11029666) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45086) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-02-16 |