| NPI | 1811734163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5383371052) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13144998052) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2024010422) | |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-07-12 |