| NPI | 1003293481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 45206) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-45206-011) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2016-10-20 |