| NPI | 1255027991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2023012425) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-82026-052) |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-04-14 |