| NPI | 1235147018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2006023496) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 15900) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 78156) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2018-06-20 |