| NPI | 1538651047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018012098) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 78165) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |