| NPI | 1760717060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5375011022) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2021021818) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2023-11-07 |