| NPI | 1407480734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79540-082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 127200) |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-07-15 |