| NPI | 1548497761 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75671-101)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3006033)  | 
| Enumeration Date | 2009-06-15 | 
| Last Update Date | 2024-09-19 |