| NPI | 1306642822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: KS 53-84081-042) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: KS 53-84081-042) |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-04-08 |