| NPI | 1245077627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-83374-111) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025027366) |
| 208D00000X General Practice (Licence: KS 53-83374-111) | |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2025-09-08 |