| NPI | 1275834517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2022007356) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-75206) |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2025-06-30 |