| NPI | 1720592082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 77942) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022006500) |
| Enumeration Date | 2017-11-24 |
| Last Update Date | 2024-04-30 |