| NPI | 1659049260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2021018999) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 5380109111) |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2021-09-14 |