| NPI | 1295371482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 80625) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-122274-042) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2021-12-27 |