| NPI | 1205353927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-77787-012) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2017027609) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |