| NPI | 1629615240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79800-011) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 116180) |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2023-11-02 |