| NPI | 1003127143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-75136-052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75136-052) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2021-02-09 |