| NPI | 1922110030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 74274) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 13-36811-072) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-07-14 |