| NPI | 1205110442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-75514-122) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5021644) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2026-01-29 |