| NPI | 1356987820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020019962) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5379533) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2020-07-08 |