| NPI | 1164008967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79703-032) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020032346) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-11-02 |