| NPI | 1023539616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 77664) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 221039035) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2024-04-30 |