| NPI | 1891839478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 44325) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 44325) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 74331) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2023-10-16 |