| NPI | 1124041579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 014042201042) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 74600) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |