| NPI | 1174208169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 82283) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14138988081) |
| 363L00000X Nurse Practitioner (Licence: MO 2023027962) | |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2024-07-26 |