| NPI | 1760996516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78029) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 115002) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2022-04-04 |