| NPI | 1205174489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75930-032) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007772) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2013-02-28 |