| NPI | 1386883841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 46283) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 13-048953) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2010010110) | |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2010-09-14 |