| NPI | 1265077937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-80579-102) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2015021068) |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2021034490) | |
| Enumeration Date | 2019-11-17 |
| Last Update Date | 2021-12-09 |