| NPI | 1245814631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80171-022) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021004374) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2022-02-01 |