| NPI | 1366903759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 78632) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019007955) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2020-08-06 |