| NPI | 1457697815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 80765) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-80765) |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2024-05-10 |