| NPI | 1477812923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75650-121) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012009899) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2018-07-09 |