| NPI | 1073963021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-77335-112) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 53-77335-112) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-12-15 |