| NPI | 1902916026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 14-34768-011) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 44311) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-09 |