| NPI | 1700525896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 81233) |
| Additional Taxonomies | 163WG0600X Registered Nurse Gerontology (Licence: KS 134036) |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2022-06-08 |