| NPI | 1740106111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-85822-092) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2026030279) |
| Enumeration Date | 2026-06-29 |
| Last Update Date | 2026-09-16 |