| NPI | 1225894835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-82960-101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024005318) |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-03-28 |