| NPI | 1134242415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 45855) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: KS 53-45855) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-45855) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2024-03-04 |