| NPI | 1992314678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82019) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023035145) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2026-06-01 |