| NPI | 1457551905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 46056) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-46056-081) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 54-46056-081) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2022-06-03 |