| NPI | 1326667155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019006499) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-79257-051) |
| Enumeration Date | 2020-04-12 |
| Last Update Date | 2024-12-20 |