| NPI | 1962513960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-44912) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 44912) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-05-02 |