| NPI | 1962935080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5380385101) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 112619) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2021-07-29 |