| NPI | 1437154408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 44775) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 44775) |
| 163W00000X Registered Nurse (Licence: KS 44775) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2020-06-02 |