| NPI | 1275868622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 75009) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2007024395) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2014-02-03 |