| NPI | 1922828755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS TMP-162697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO F10240159) |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2025-02-17 |