| NPI | 1619431426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81170-102) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177205) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2025-06-18 |