| NPI | 1811366925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-76933) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015034069) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2022-05-27 |