| NPI | 1851109029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-84019) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 76078) |
| Enumeration Date | 2024-12-20 |
| Last Update Date | 2025-05-20 |