| NPI | 1083478903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82873-052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024004218) |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |