| NPI | 1780187179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5378317051) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2018007933) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2026-01-28 |