| NPI | 1639833155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-80648-052) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: KS 53-80648-052) |
| Enumeration Date | 2021-10-30 |
| Last Update Date | 2025-07-10 |