| NPI | 1922786680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KS 117716) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-84397-091) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2025-10-09 |