| NPI | 1881053544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016001668) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77135) |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2016-07-19 |