| NPI | 1134801236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 84018) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 127521) |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2025-01-31 |