| NPI | 1629602024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-82452-092) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2020006521) |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2025-04-04 |