| NPI | 1093199051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76839-011) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015009931) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2022-01-04 |