| NPI | 1386485464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-83217-032) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2019034360) |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2024005899) | |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2024-06-04 |