| NPI | 1750207858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-85863-021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2026029336) |
| Enumeration Date | 2026-06-24 |
| Last Update Date | 2026-07-14 |