| NPI | 1023666336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78790) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 78790) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2024-12-13 |