| NPI | 1083172555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78583-072) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-127389-072) |
| 163W00000X Registered Nurse (Licence: MO 2023002033) | |
| 363L00000X Nurse Practitioner (Licence: MO 2023002542) | |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2024-08-23 |