| NPI | 1659756914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 72101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015023467) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79107-092) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2023-10-19 |