| NPI | 1689320087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5380907121) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1069096) |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2024-07-15 |