| NPI | 1871915322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0991178) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76229) |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2016-04-15 |