| NPI | 1407191703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375693082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1392045082) |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2022-07-21 |