| NPI | 1548509359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75921-062) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-100459-062) |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2015-11-04 |