| NPI | 1508201963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375975081) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013006422) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2024-04-20 |