| NPI | 1396095899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 75961) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR mh4719588) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2012031980) | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2018-09-27 |