| NPI | 1720476559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76647-061) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014044173) |
| Enumeration Date | 2015-01-01 |
| Last Update Date | 2023-10-24 |