| NPI | 1891440608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5380700021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021035675) |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2022-06-02 |