| NPI | 1700240108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 14-134864-041) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 200400751) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2016012217) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-06-13 |