| NPI | 1972616688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 142295) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 77216) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2018-03-17 |