| NPI | 1053681049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 75524) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 78516) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2015-10-01 |