| NPI | 1952733149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76056) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-76056) |
| 363L00000X Nurse Practitioner (Licence: KS 5376056) | |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2020-03-20 |