| NPI | 1730078478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-84646-082) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 136435) |
| 163WE0003X Registered Nurse, Emergency (Licence: KS 136435) | |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-08-13 |