| NPI | 1609838424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 77456) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-77456-112) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2021-10-27 |