| NPI | 1063784023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75556-061) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012004974) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2014-02-20 |