| NPI | 1225603624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80143-021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021010430) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2022-06-28 |