| NPI | 1306244611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76358-121) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: KS 030263) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2015-06-24 |