| NPI | 1528315207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 75738) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1014133) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2020-12-03 |