| NPI | 1619837689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2025049901) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13144754042) |
| Enumeration Date | 2025-11-13 |
| Last Update Date | 2026-03-03 |