| NPI | 1497147110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015002159) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5376685121) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-03-30 |