| NPI | 1689264335 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80080-032)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2021002930)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2021002930)  | |
| Enumeration Date | 2021-01-26 | 
| Last Update Date | 2024-09-16 |