| NPI | 1457623761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 76153) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012002374) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2023-04-20 |