| NPI | 1558492447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 107568) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45337) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-05-11 |