| NPI | 1780420083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-83388-122) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2024007929) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2024007929) | |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2026-08-28 |