| NPI | 1225621600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS F01210769) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80013-022) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-02-23 |