| NPI | 1124207667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 46126) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2009031635) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2023-08-08 |