| NPI | 1235478058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 75881) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111460) |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2015-09-25 |