| NPI | 1497159669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2014031474) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 53-76549-082) |
| 363LF0000X Nurse Practitioner Family (Licence: AK 132720) | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2018-05-22 |