| NPI | 1417377094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013033429) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 77104) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2018-02-15 |