| NPI | 1306345277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78063-092) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2018002777) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2021-06-30 |