| NPI | 1558367755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-45257-032) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 45257) |
| 363L00000X Nurse Practitioner (Licence: KS 53-45257-032) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-45257-032) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2022-05-19 |