| NPI | 1366069858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79606) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 127102) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2021-09-10 |