| NPI | 1063193191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-82878-082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2009036448) |
| 163W00000X Registered Nurse (Licence: KS 13-100269-082) | |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2024015242) | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2024-05-14 |