| NPI | 1023615648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79752-112) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 53-79752-112) |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2023-05-17 |