| NPI | 1134726466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 79665) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 53-79665-102) |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2024-03-01 |