| NPI | 1194194613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 76914) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-112404-121) |
| 163W00000X Registered Nurse (Licence: MO 2010018774) | |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |