| NPI | 1982124491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201800838NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011373) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2018-10-11 |