| NPI | 1902501174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82773-051) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024020453) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2025-06-03 |