| NPI | 1255758801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76212-082) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2014004551) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2023-06-28 |