| NPI | 1154195303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024009166) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2019022277) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 5383564062) | |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2024-12-17 |