| NPI | 1023393634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75326-122) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 57-75326-122) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2021-05-03 |