| NPI | 1508133349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-75519) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 106457) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2022-02-09 |