| NPI | 1730714155 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-79715) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 363L00000X Nurse Practitioner (Licence: MO 2020030794) | |
| Enumeration Date | 2020-03-05 | 
| Last Update Date | 2022-01-26 |