| NPI | 1104327576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78077-041) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018004095) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2024-07-22 |