| NPI | 1780967687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 75462) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 530115) |
| 163W00000X Registered Nurse (Licence: KS 116553) | |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-09-27 |