| NPI | 1508593187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-161108) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-109558) |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-09-14 |