| NPI | 1609117555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78303-102) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NV TAPN700890) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2019-06-03 |