| NPI | 1578791919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2006023774) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75023-041) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2021-04-26 |