| NPI | 1740046077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-82956) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS TMP-162253) |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2025-02-12 |