| NPI | 1982085338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110285) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76846) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2015023428) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2022-08-08 |