| NPI | 1740878750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79882-081) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021001097) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2022-10-27 |