| NPI | 1114399706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-7948-122) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2020010292) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2020010917) | |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2024-07-25 |