| NPI | 1437818135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5380729022) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021029668) |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2021-12-10 |