| NPI | 1487953261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011003418) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75244-011) |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2021-08-11 |