NPI | 1013476704 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78630-081) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 78630) |
Enumeration Date | 2019-03-13 |
Last Update Date | 2025-09-08 |