| NPI | 1669407292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 45882) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 155018) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 213380-7) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-12-07 |