| NPI | 1124326293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375258012) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011026919) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2014-07-20 |