| NPI | 1639623812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 242949) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 77337) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2016028863) | |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2021-06-24 |