| NPI | 1851757728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77111-122) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015044720) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2019-04-22 |