| NPI | 1801171707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 75234) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75234-051) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2023-09-14 |