| NPI | 1811278526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-75469) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2012000257) |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2014-01-09 |