| NPI | 1740481647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KS 13055671122) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 44844) |
| 363L00000X Nurse Practitioner (Licence: KS 74292) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2007-07-08 |