| NPI | 1184143752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-77927) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KS 85526) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2017-10-19 |