| NPI | 1366789471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9455814) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9455814) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75887-112) | |
| Enumeration Date | 2013-01-09 |
| Last Update Date | 2020-09-16 |