| NPI | 1902228679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 76413) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014000954) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76412-031) | |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2018-05-18 |