| NPI | 1689178550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 77796) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018010811) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2026-03-18 |