| NPI | 1669564332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KS 142497611) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 5344213) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-07-09 |