| NPI | 1700844115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-45630-082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-589920-082) |
| 363L00000X Nurse Practitioner (Licence: KS 45630) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2019-11-11 |