| NPI | 1205482775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019040280) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-136773-091) |
| 163W00000X Registered Nurse (Licence: MO 2016022060) | |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2024-01-02 |