| NPI | 1265153449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81232-081) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022017633) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2022-09-07 |