| NPI | 1326595042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77786) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-104386-082) |
| Enumeration Date | 2016-09-10 |
| Last Update Date | 2018-03-17 |