| NPI | 1912291386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011004376) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 75317) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2016-04-18 |