| NPI | 1780199901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 77864) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 77864) |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2022-08-15 |