| NPI | 1114976271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 13-069081-101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 003174) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2019-08-20 |