| NPI | 1710758743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82712-081) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023047871) |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-04-13 |