| NPI | 1619448552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78494-011) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025031022) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2025-09-25 |