| NPI | 1578929030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5344333012) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1359108012) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |