| NPI | 1053845966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017001816) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-134081-031) |
| 163W00000X Registered Nurse (Licence: MO 2008021001) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77571-031) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2022-04-22 |