| NPI | 1073510764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 45384) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 121186) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2016-11-30 |