| NPI | 1124495049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 78054) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KS 116813) |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2018-03-23 |