| NPI | 1598375636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5380187022) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021015292) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2023-06-06 |