| NPI | 1760980866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018031876) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 78072) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2024-05-06 |