| NPI | 1629708854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82298-052) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-14525-052) |
| Enumeration Date | 2022-06-11 |
| Last Update Date | 2023-08-09 |