| NPI | 1902842644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 1331700031) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 44636) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2007-07-08 |