| NPI | 1760871487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014042978) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76504-011) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-01-19 |