| NPI | 1114465457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017003632) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-77569-101) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2024-11-13 |