| NPI | 1730726084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78798-052) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2019032482) |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2022-08-26 |