| NPI | 1952134595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5383502071) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 53-83502-071) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2025-07-22 |