| NPI | 1801389515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5380099101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017769) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2022-03-09 |