| NPI | 1124747142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2022039659) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MO 2018021440) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-81719-051) | |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2023-03-06 |