| NPI | 1295402303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KS 93678) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 207949) |
| 363LF0000X Nurse Practitioner Family (Licence: AK 210334) | |
| 363LF0000X Nurse Practitioner Family (Licence: KS 53-82301-102) | |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2023-06-29 |