| NPI | 1639633282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WI 12022) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14131720012) |
| 163W00000X Registered Nurse (Licence: MO 2014013260) | |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2020019707) | |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2022-08-08 |