| NPI | 1184260374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 79246) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-159203) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2022-10-03 |