| NPI | 1942600341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5376432051) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014026223) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2015-07-02 |