| NPI | 1114759081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-84539) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RN306903) |
| 363L00000X Nurse Practitioner (Licence: MO 2025019608) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN306903) | |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2025-09-09 |