| NPI | 1154702793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-76807-051) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 76807) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2022-07-05 |