| NPI | 1124652441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-81258-051) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 101874) |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2022-06-10 |