| NPI | 1306611413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-84002-052) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9539287) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11031234) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001656) | |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2025-05-12 |