| NPI | 1356065494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2022040708) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-82063-112) |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2025-10-02 |