| NPI | 1356048912 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-81922-091)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2023005120)  | 
| Enumeration Date | 2023-02-13 | 
| Last Update Date | 2023-10-03 |