| NPI | 1902205297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2014028415) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 76443) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2014-09-22 |