| NPI | 1861448789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AR A03162) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 129126) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 45502) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2020-04-17 |