| NPI | 1154701456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-76744-031) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2015009934) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2022-07-21 |