| NPI | 1477104453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78924-021) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021040574) |
| Enumeration Date | 2019-09-22 |
| Last Update Date | 2025-03-26 |