| NPI | 1568082048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 5379974061) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-128476-061) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2024-07-12 |