| NPI | 1679160915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79869-012) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-119399-012) |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2022-02-11 |