| NPI | 1396091153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-75735) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-110159) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2013-03-26 |