| NPI | 1821714445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5381438101) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022046846) |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2025-02-07 |