| NPI | 1518425651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2022046991) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 78651) |
| 363L00000X Nurse Practitioner (Licence: KS TMP-158064) | |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2022-12-02 |