| NPI | 1073219457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 82024) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2023048917) |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2025-07-24 |