| NPI | 1730715236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5378983021) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1398582021) |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-12-03 |