| NPI | 1760953079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5378534052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 104982) |
| Enumeration Date | 2018-12-12 |
| Last Update Date | 2022-11-18 |