| NPI | 1891124798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 76576) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2013039638) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2015-01-30 |