| NPI | 1689138661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021008260) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-124595-041) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79257) | |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2024-02-27 |