| NPI | 1922454321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-77234) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016010710) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77234-071) | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2021-01-07 |