| NPI | 1356792014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-77242) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5377242092) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2022-07-12 |