| NPI | 1811329774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76049-021) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 13-94813) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2014-01-03 |