| NPI | 1568188068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-81360-032) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 2021209649) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2023-02-23 |