| NPI | 1174959365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013032468) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 65688) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79796-122) | |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2022-10-18 |