| NPI | 1760068308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80139-051) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021010386) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2023-09-29 |