| NPI | 1073135430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78921-052) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: KS 13-111822-052) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |