| NPI | 1821675638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80298-122) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13131760122) |
| 163W00000X Registered Nurse (Licence: MO 2016013203) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2021028397) | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2022-01-21 |