| NPI | 1720610744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79235-122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO m2020011703) |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2021-02-16 |