| NPI | 1316665342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81417-111) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022001279) |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-08-29 |