| NPI | 1154656395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-75100-042) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-88364-042) |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2022-03-14 |