| NPI | 1720869845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82620-021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023039402) |
| Enumeration Date | 2023-10-13 |
| Last Update Date | 2024-12-05 |