| NPI | 1255697793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-84126-092) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4447) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2025-09-17 |