| NPI | 1962741967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 3-000797) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS TMP 146392) |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2023-10-05 |