| NPI | 1942619689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 76511) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 107965) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-26 |