| NPI | 1790239978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016023923) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5376917) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-10-07 |