| NPI | 1467824136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015034074) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77324-102) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2020-08-13 |