| NPI | 1740931567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-163147) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-115996-022) |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2025-09-12 |