| NPI | 1699215822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5377547111) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016045017) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2021-08-30 |