| NPI | 1477440972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-84475-052) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025009910) |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2026-01-14 |