| NPI | 1902075641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-46123) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 46123) |
| 363L00000X Nurse Practitioner (Licence: MO 2011030977) | |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2025-06-16 |