| NPI | 1568195816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024012717) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81359-072) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-160931) | |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2025-04-13 |