| NPI | 1275828030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902549) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 118108) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2018-06-06 |