| NPI | 1407814692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5345839022) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: KS 45839) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2010-11-19 |