| NPI | 1821651167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78794-091) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2011017582) |
| 163W00000X Registered Nurse (Licence: KS 14-118410-091) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2019019672) | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-07-24 |