| NPI | 1710055082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-46132-032) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2006001233) |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2022-08-19 |