| NPI | 1639832488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5379917062) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A165448) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2023-03-16 |