| NPI | 1740721083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5377582) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017007333) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |