| NPI | 1851458996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-74946-122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 627339) |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2015-04-24 |