| NPI | 1548718935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77379-021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-153381) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2023-03-09 |