| NPI | 1538858337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2023008001) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS TMP-161410) |
| 363L00000X Nurse Practitioner (Licence: KS 53-82200-071) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-161410) | |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-18 |