| NPI | 1447582721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-45966) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010003777) |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2019-06-07 |