| NPI | 1891222865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 77622) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77622) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 77622) | |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2022-07-21 |