| NPI | 1629726369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5380992051) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022005938) |
| Enumeration Date | 2022-03-11 |
| Last Update Date | 2022-03-11 |