| NPI | 1164185690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5380423022) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021029245) |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2023-12-22 |