| NPI | 1548600653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-75901-032) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2013021221) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2013-10-09 |