| NPI | 1992417679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81899-102) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-152087-102) |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2023-01-31 |