| NPI | 1124642145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020018077) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2013011059) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79942-081) | |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2022-01-09 |