| NPI | 1275020190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 78170) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 95692) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2020-05-15 |