| NPI | 1376046607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 78371) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 111828) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-12-03 |