| NPI | 1629968516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2025008466) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS TMP-162879) |
| Enumeration Date | 2025-07-03 |
| Last Update Date | 2025-07-03 |