| NPI | 1306958327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 44562) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 13-24757-091) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-09 |