| NPI | 1063183168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80541-091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021012243) |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2025-11-04 |