| NPI | 1780357202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-83004-012) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-134956-012) |
| 363L00000X Nurse Practitioner (Licence: MO 2024005947) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-83004-012) | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2025-04-07 |