| NPI | 1194830216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 45560) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: KS 74773) |
| 163W00000X Registered Nurse (Licence: KS 13-47864-091) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2010-01-11 |