| NPI | 1811503345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80523-031) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1011827) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2021-11-29 |