| NPI | 1154927606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5379804051) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-79804-051) |
| 363L00000X Nurse Practitioner (Licence: MO 2020039162) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2020039162) | |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2024-05-07 |