| NPI | 1528575560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017039221) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 5378078) |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2021-12-06 |