| NPI | 1487149068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-80456) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RN245617) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2021-12-01 |