| NPI | 1619486693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75850-031) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 78580) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2019-04-08 |