| NPI | 1356051387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 53-81878-061) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2023006115) |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2023-11-03 |