| NPI | 1750663803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79334) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO NP-990143) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2020225623) | |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2020-05-13 |