| NPI | 1942632435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS tmp147584) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-121952-022) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2013-09-09 |