| NPI | 1932731049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79520-032) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 123180) |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-07-08 |