| NPI | 1184230534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79613-072) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020022574) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2023-10-27 |