| NPI | 1659787281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 76674) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014011108) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-05-04 |