| NPI | 1154317972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 089293) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82339-031) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2025-01-06 |