| NPI | 1629621941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019027103) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-80676) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2025-04-14 |