| NPI | 1376163089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS F07201224) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 104843) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2021-03-18 |