| NPI | 1295087138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78000-031) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2012014784) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2019-11-22 |