| NPI | 1609425008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019034297) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78929-071) |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2019-09-09 |