| NPI | 1578110847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019010062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5378919) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-12-06 |