| NPI | 1003461146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 80828) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95015958) |
| 363L00000X Nurse Practitioner (Licence: CT 8880) | |
| 363L00000X Nurse Practitioner (Licence: MD R237998) | |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2023-10-11 |