| NPI | 1063044485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 79491) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: KS 124368) |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-10-29 |