| NPI | 1417241993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75404-052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP142899) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2012-02-15 |