| NPI | 1538780176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 79453) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 86657) |
| 163W00000X Registered Nurse (Licence: MO 2017026463) | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2022-06-14 |