| NPI | 1912250952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK F0812124) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK R0093051) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2020-07-14 |