| NPI | 1548861537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79348-072) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2012010426) |
| 163W00000X Registered Nurse (Licence: KS 14-150030-072) | |
| 363L00000X Nurse Practitioner (Licence: MO 2020005245) | |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |