| NPI | 1003957192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: KS X02-18-5388) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-159044-071) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2019-06-24 |