| NPI | 1124468335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76149) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 43877) |
| 363L00000X Nurse Practitioner (Licence: KS 43877) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2018-03-28 |