| NPI | 1104225077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KS 124664) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 1136626) |
| Enumeration Date | 2014-08-17 |
| Last Update Date | 2024-10-23 |