| NPI | 1467992057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 77583) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017006966) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2018-04-06 |