| NPI | 1629362645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75912-101) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011017381) |
| 363LX0106X Nurse Practitioner, Occupational Health (Licence: KS 53-75912-101) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2023-08-25 |