| NPI | 1386205961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78899) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019021991) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2023-05-15 |