| NPI | 1003161548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5377136062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R190962) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2020-08-27 |