| NPI | 1801618509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2024044294) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2016019951) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 22832863) | |
| Enumeration Date | 2024-10-25 |
| Last Update Date | 2024-12-08 |