| NPI | 1124003520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-44959-111) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-66675-111) |
| 363LX0106X Nurse Practitioner, Occupational Health (Licence: KS 44959) | |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2016-11-18 |