| NPI | 1902078702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2001029543) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 46189) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2020-01-24 |