| NPI | 1225611841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-80369-101) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-119091-101) |
| 163W00000X Registered Nurse (Licence: MO 2015042539) | |
| 363L00000X Nurse Practitioner (Licence: MO 2021028670) | |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2024-03-29 |