| NPI | 1619499670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5377522082) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2019019299) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2025-09-17 |