| NPI | 1770997470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76283) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 53 76283) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2025-06-10 |