| NPI | 1073943064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS KS5376156111) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: KS KS5374433111) |
| 364S00000X Clinical Nurse Specialist (Licence: MO 2013038958) | |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2013-11-15 |