| NPI | 1265902076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5378108101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018011105) |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2020-02-27 |