| NPI | 1891179057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015019820) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76874) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2015-08-27 |