| NPI | 1003858960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-45255-101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45255) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2010-07-29 |