| NPI | 1740645001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 5376931041) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2015042086) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2017-05-01 |