| NPI | 1942679675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015040101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76851) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2022-07-08 |