| NPI | 1922642032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 79158) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK R0083528) |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2019-12-20 |