| NPI | 1215952742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 125117) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS Q42098) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 45682) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-01-13 |