| NPI | 1679972731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76451) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 53-76451) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2024-09-03 |