| NPI | 1336404524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-75589) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 75589) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 75589) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: KS 75589) | |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2023-06-03 |