| NPI | 1013070390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 1352084082) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45355) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: KS 44247) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-08 |