| NPI | 1366095283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78873-122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019014584) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2021-03-26 |