| NPI | 1215647359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-83358-062) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2022046623) |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2024-07-15 |