| NPI | 1295006096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 75581) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75581-081) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2017-03-31 |