| NPI | 1366940439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019016092) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78004-031) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2019-08-23 |