| NPI | 1730014663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2026003926) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-85260-012) |
| Enumeration Date | 2026-06-13 |
| Last Update Date | 2026-06-13 |