| NPI | 1063802585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76700-121) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 76700) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2021-12-03 |