| NPI | 1740464197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11393283-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 46103) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2021-11-01 |