| NPI | 1629644604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 80217) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 105109) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2023-09-01 |