| NPI | 1558791236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76083-011) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5376083011) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2024-04-11 |