| NPI | 1376308486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-82904-091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82904-091) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 82904) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-82904-091) | |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2025-12-29 |