| NPI | 1568071215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79458) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 53-79458) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2024-03-29 |