| NPI | 1750721957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 76131) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 110156) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2024-01-09 |