| NPI | 1164259750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-84202-061) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-165269-061) |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2025-03-25 |