| NPI | 1497724553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 45552) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 13-86581-012) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2021-12-03 |