| NPI | 1730744863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 78716) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78716-062) |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2022-03-30 |