| NPI | 1962893263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011005719) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76730) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2023-12-07 |