| NPI | 1144610049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2021030684) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 76601) |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2022-01-04 |