| NPI | 1205445061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 81196) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 144909) |
| 363L00000X Nurse Practitioner (Licence: KS 81196) | |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2022-10-13 |