| NPI | 1902877376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2004030054) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45707) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2016-04-04 |