| NPI | 1205175577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-46306-042) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ID 53105) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2022-04-19 |