| NPI | 1679809719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 75029) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2014029940) |
| Enumeration Date | 2009-10-25 |
| Last Update Date | 2021-09-11 |