| NPI | 1972838621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0990553) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-74980-071) |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2018-08-27 |