| NPI | 1316513260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-80334) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5380334062) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2021019487) | |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2022-02-08 |