| NPI | 1952730590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5376022) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2013037709) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2022-01-24 |