| NPI | 1134883614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2021046260) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2004018496) |
| 163W00000X Registered Nurse (Licence: KS 14-113338-032) | |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2021-12-21 |