| NPI | 1821497496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP149621) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015034754) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2017-10-05 |