| NPI | 1871274506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81990-082) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023024708) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2023-07-26 |