| NPI | 1508144379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75511-031) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011019323) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2013-04-05 |