| NPI | 1699081653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75172-062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014042638) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2018-08-16 |