| NPI | 1972220275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-81682) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2022034602) |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2022-11-01 |