| NPI | 1760092894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-79518) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-79518-021) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79518) | |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2022-04-05 |