| NPI | 1295606390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025042943) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13144898122) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-84915-122) | |
| Enumeration Date | 2025-09-13 |
| Last Update Date | 2025-10-28 |