| NPI | 1063297810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82249-051) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023032941) |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2023-09-15 |