| NPI | 1972064202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81802-092) |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2023-01-19 |