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 |