| NPI | 1982221073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79525) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79525-091) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2021-08-03 |