| NPI | 1700456589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80301-092) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-101872-092) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2021045608) | |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2024-07-30 |