| NPI | 1154019255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5382279081) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2023004370) |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2023-10-10 |