| NPI | 1073397907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-83293-121) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: KS 53-83293-121) |
| 163W00000X Registered Nurse (Licence: KS 14-145718-121) | |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2024-10-23 |