| NPI | 1922573880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78419-061) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2013042445) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-12-18 |