| NPI | 1568808061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012041205) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75768-022) |
| Enumeration Date | 2013-05-12 |
| Last Update Date | 2022-01-20 |