| NPI | 1134398092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 46108) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 46108) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-46108-102) | |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2017-02-27 |