| NPI | 1871131938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78867-011) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2019021909) |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |