| NPI | 1861024663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79352-052) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 121783) |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2021-04-26 |