| NPI | 1760687289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 46031) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 13-87416-072) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2018-12-18 |