| NPI | 1902862758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-45354) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 13468060052) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2019-03-19 |