| NPI | 1497430425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-84632-062) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2025043454) |
| 163W00000X Registered Nurse (Licence: KS 145426) | |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2025-10-17 |