| NPI | 1477519924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 13-64331-010) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 45394) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2010-03-26 |