| NPI | 1457814022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 78767) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007018877) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-07-15 |