| NPI | 1497263024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 78800) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017044571) |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2019-08-23 |