| NPI | 1174913719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017004958) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 77608) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2022-04-15 |