| NPI | 1104577931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5380282042) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021051086) |
| 163W00000X Registered Nurse (Licence: KS 14128752042) | |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2024-07-26 |