| NPI | 1720019276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 45805) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1341823061) |
| 207Q00000X Family Medicine (Licence: KS 04-45805) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2013-07-11 |