| NPI | 1164554994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79064-021) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024167272) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2025-03-11 |