| NPI | 1811869704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 53-84776-012) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2025041685) |
| Enumeration Date | 2025-09-19 |
| Last Update Date | 2025-11-06 |