| NPI | 1700401163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5379421111) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 79421) |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2023-08-08 |