| NPI | 1811200058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 5375122051) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2010022208) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2023-09-21 |