| NPI | 1487022471 |
|---|---|
| Former Name | KYLIE ANNE IMMETHUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76912) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 111908-101) |
| 163W00000X Registered Nurse (Licence: MO 20120231117) | |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2024-05-17 |