| NPI | 1700394699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78011-062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2018041540) |
| Enumeration Date | 2018-01-13 |
| Last Update Date | 2024-03-11 |