| NPI | 1821651167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78794-091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019019672) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2024-07-18 |