| NPI | 1902399165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: KS 53-78238-072) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-118679-072) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2020-12-02 |