| NPI | 1992716138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KS 13-73679-072) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 45795) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 45795) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-07-09 |