| NPI | 1508456476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-79841) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 79841) |
| Enumeration Date | 2021-01-24 |
| Last Update Date | 2021-03-05 |