| NPI | 1629213665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 75458) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 102604) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75458-101) | |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2024-02-19 |