| NPI | 1295903623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 102512) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 44592) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2020-11-25 |