| NPI | 1194581710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 83124) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS F02240551) |
| 208D00000X General Practice (Licence: KS 139940) | |
| Enumeration Date | 2024-02-21 |
| Last Update Date | 2025-08-27 |