| NPI | 1679191803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 79544) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79544-051) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2024-11-27 |