| NPI | 1639884612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81021-051) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 81021) |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2026-05-15 |