| NPI | 1780432542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-84636) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-129182) |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2026-02-23 |