| NPI | 1568425270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-44637) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 44637) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2022-06-01 |