| NPI | 1699522839 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-84338-012)  | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: KS 13-151652-012)  | 
| Enumeration Date | 2024-05-06 | 
| Last Update Date | 2025-10-24 |