| NPI | 1336345198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KS 14-67059-111) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 74682) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2007-07-08 |