| NPI | 1720698772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79619-121) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 159547) |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-08-17 |