| NPI | 1558693416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53074908032) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010004350) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2016-02-04 |