| NPI | 1154100519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2025020545) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-84440-022) |
| 363L00000X Nurse Practitioner (Licence: PA SP029365) | |
| 363L00000X Nurse Practitioner (Licence: CA 95026440) | |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2025-07-02 |