| NPI | 1689866568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 46097) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 123181) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2020-05-15 |