| NPI | 1003066085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 75561) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2004015211) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2020-02-07 |