| NPI | 1336592930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011017813) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP153102) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2020-12-23 |