| NPI | 1750393898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-45755) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45755) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2013-11-11 |