| NPI | 1942498787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-46102) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1490870082) |
| 163W00000X Registered Nurse (Licence: MO 2002019680) | |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2018-01-29 |