| NPI | 1609271709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-77112) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2014035618) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2025-02-12 |