| NPI | 1508172552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-75191-071) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-71194-071) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75191-071) | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2020-03-04 |