| NPI | 1730854647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80291-022) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021026488) |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2021-11-23 |