| NPI | 1922426519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76828) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2014004554) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2003016258) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2023-03-22 |