| 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 | 2022-10-07 |