| NPI | 1407164296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75361-071) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010030910) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2023-08-10 |