| NPI | 1194255125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 77805) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 98848) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2026-04-06 |