| NPI | 1578917704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-77181-011) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77181-011) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2017-03-10 |