| NPI | 1528263142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-45211) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 13-78775-081) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2010-07-07 |